Myasthenia gravis

Myasthenia gravis is an autoimmune neuromuscular disease characterized with degeneration of the muscles resulting in fatigue and general weakness caused by the malfunctioning of the thymus gland. The thymus gland over-produces antibodies that block the action of tyrosine kinase and acetylcholine. Genetic factors are also blamed for the onset of this disease.

Symptoms

The main symptom is fatigue and it is usually observed first in the eye muscles. Slurred speech and feelingdifficulty in swallowing follows. The symptoms are pronounced during periods of activity and they subside following periods of rest.

Tests

Diagnosis of myasthenia gravis is difficult due to the subtlety of the symptoms and the similarity with other neurological disorders. Usually, a physical examination is done, followed by blood tests. Electrodiagnostics have also been proved to be useful, but not conclusive in all cases. Sensitivity to ice through the “ice test” is another method in vogue. Additionally, an endrophonium test can be done along with imaging (chest X-ray) and a pulmonary function test.

Treatment

Usually, immunosuppressive drugs are administered for the treatment of this disease, but Plasmapheresis is resorted to in extreme cases for expulsion of putative antibodies. Intravenous Immunoglobulins (IVIGs) are also found to be effective in such cases. Sometimes, surgical removal of the thymus is carried out.

Prognosis

There is no negative impact on life expectancy. However, there is a considerable impact from side effects of immunosuppressants. Although the disease is likely to remain for the remainder o the patient’s life, sometimes the symptoms decrease after a period of 3 to 5 years.

Prevention

Although myasthenia gravis cannot be entirely prevented, there are certain measures that can be taken to reduce it from occurring. Contributing factors which need to be avoided are emotional stress, illness, including fever, and avoiding certain drugs which believed to trigger the disease and following a balanced, healthy diet which should include maintaining adequate levels of potassium in the blood.

Treatment Cost

The cost of treatment is rather high, as thousands of dollars may be spent on the initial tests, and if surgery is involved, then the expenditure can increase exponentially. The treatment cost largely depends on the severity of the disease and its duration.